PD405 - RISK FACTORS FOR LOSS OF SKELETAL MUSCLE MASS IN PATIENTS WITH CHRONIC KIDNEY DISEASE ON A LOW-PROTEIN DIETS

PD405

RISK FACTORS FOR LOSS OF SKELETAL MUSCLE MASS IN PATIENTS WITH CHRONIC KIDNEY DISEASE ON A LOW-PROTEIN DIETS

S. Notomi^1,2,*, H. Kabasawa³, M. Tanaka¹, T. Murayama⁴, S. Yamamoto¹, M. Hosojima³

¹Department of Clinical Nephrology and Rheumatology, Kidney Research Center, Niigata University Graduate School of Medical and Dental Sciences, ²Department of Health and Nutrition, Faculty of Health Sciences, Niigata University of Health and Welfare, ³Department of Clinical Nutrition Science, Kidney Research Center, Niigata University Graduate School of Medical and Dental Sciences, ⁴Department of Health Nutrition, University of Niigata Prefecture Faculty of Human Life Studies, Niigata, Japan

Rationale: A low-protein diet (LPD) is recommended for patients with chronic kidney disease (CKD) to prevent a further decline in renal function. However, its impact on muscle mass in these patients remains unclear. This study investigated the risk factors for loss of muscle mass in patients with CKD on an LPD.

Methods: 84 patients with pre-dialysis CKD (59 men, mean age 61.9 ± 11.5 years) who participated in a multicenter randomized controlled trial performed initiated in 2014 were retrospectively reviewed. We collected data on baseline blood and urine tests, body composition, and dietary records at the start and end of the observation period. We evaluated muscle mass using the skeletal muscle index (SMI) and risk factors for a reduced SMI during 24 weeks of observation by logistic regression analysis. Variables with an association (p<0.1) in univariate analysis as well as age, sex, use of low-protein rice, and changes in protein intake were subjected to multivariate analysis.

Results: SMI decreased in 50 patients (59.5%) during the observation period. Multivariate analysis identified significant associations of the SMI with serum albumin at baseline (odds ratio 0.11, 95% confidence interval 0.02–0.52, p=0.004) and changes in energy intake while on the LPD (odds ratio 3.39, 95% confidence interval 1.00–11.43, p=0.049).

Conclusion: Risk factors for reduced SMI in patients with CKD on an LPD were malnutrition when initiating the LPD and reduced energy intake during its implementation. Clinicians should optimize nutritional status before initiation of an LPD and ensure adequate energy intake throughout treatment.

Disclosure of Interest: S. Notomi: None declared, H. Kabasawa Grant / Research Support from: Kameda Seika Co., Ltd.（€26,900）, Biotech Japan Corporation（€53,800）, Forica Foods Co., Ltd.（€26,900）, M. Tanaka: None declared, T. Murayama: None declared, S. Yamamoto: None declared, M. Hosojima Grant / Research Support from: Kameda Seika Co., Ltd.（€26,900）, Biotech Japan Corporation（€53,800）, Forica Foods Co., Ltd.（€26,900）